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Xu P, Cui C, Liu Y, Fang K, Wang Q, Liu C, Tan R. Case report: Herbal treatment of neutropenic enterocolitis after chemotherapy for breast cancer. Open Life Sci 2023; 18:20220753. [PMID: 37941783 PMCID: PMC10628586 DOI: 10.1515/biol-2022-0753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 11/10/2023] Open
Abstract
In this case report, a 53-year-old woman was diagnosed with severe NE after receiving chemotherapy for breast cancer. The patient with breast cancer was treated with a single cycle of docetaxel (140 mg) + epirubicin (130 mg) + cyclophosphamide (0.9 g) chemotherapy. However, the woman presented with symptoms of fatigue and diarrhea 5 days later accompanied with severe neutropenia according to the routine blood test. The computed tomography examination displayed the thickening and swelling of the colorectal wall. After the diagnosis of NE, the woman received antibiotics and supportive treatment, but her symptoms were not improved. The Chinese herbal medicine (CHM) diagnostic pattern was then designed for the patient. The patient was administered with two CHM decoctions. One decoction contained 24 kinds of herbal materials, and the other one was called pure ginseng decoction. These two decoctions were administered to the patient 2 or 3 times per day to tonify the spleen, nourish Qi and blood, and remove phlegm and damp heat symptoms. After the CHM treatment lasting for 10 days, the symptoms of the patient were improved, and she was discharged. In conclusion, CHM treatment played an indispensable role in curing the woman with chemotherapy-induced NE.
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Affiliation(s)
- Peng Xu
- Galactophore Department, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, No. 127, Si-Liu South Road, Qingdao266042, China
| | - Chaoxiong Cui
- Ophthalmology Department, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, No. 127, Si-Liu South Road, Qingdao266042, China
| | - Yukun Liu
- Galactophore Department, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, No. 127, Si-Liu South Road, Qingdao266042, China
| | - Kun Fang
- Galactophore Department, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, No. 127, Si-Liu South Road, Qingdao266042, China
| | - Qitang Wang
- Galactophore Department, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, No. 127, Si-Liu South Road, Qingdao266042, China
| | - Chao Liu
- Health Management Department, Ophthalmology Department, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, No. 127, Si-Liu South Road, Qingdao266042, China
| | - Ruixia Tan
- Health Management Department, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, No. 127, Si-Liu South Road, Qingdao266042, Shandong, China
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Naman J, Saglamer N, Yock T, Pugh J, Pastena G, Weintraub L. Posterior reversible encephalopathy syndrome and necrotizing enterocolitis in a pediatric patient with medulloblastoma and COVID-19 infection. Pediatr Blood Cancer 2023; 70:e29868. [PMID: 35841310 PMCID: PMC9349640 DOI: 10.1002/pbc.29868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/25/2022]
Affiliation(s)
| | - Nicole Saglamer
- Department of PediatricsAlbany Medical CenterAlbanyNew YorkUSA
| | - Torun Yock
- Department of Radiation OncologyMassachusetts General HospitalBostonMassachusettsUSA
| | - John Pugh
- Department of Child NeurologyAlbany Medical CenterAlbanyNew YorkUSA
| | - Gaetano Pastena
- Department of RadiologyAlbany Medical CenterAlbanyNew YorkUSA
| | - Lauren Weintraub
- Department of Pediatric NeurooncologyAlbany Medical CenterAlbanyNew YorkUSA
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Dube MD, Sapkota S, Lakhatariya K, Russo A. COVID-19 and Subsequent Development of Pancytopenia With Concurrent Disseminated Intravascular Coagulation. Cureus 2022; 14:e32845. [PMID: 36694508 PMCID: PMC9867565 DOI: 10.7759/cureus.32845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Complications resulting from coronavirus disease 2019 (COVID-19) sequelae have been well documented. These include blood conditions such as lymphopenia, thrombocytopenia, and hypercoagulability. Less common problems that may arise are disseminated intravascular coagulation (DIC), immune thrombocytopenic purpura (ITP), and pancytopenia. Furthermore, the majority of COVID-19 patients to develop pancytopenia have been immunosuppressed. We present a case of a previously immunocompetent patient who subsequently developed pancytopenia, DIC, as well as symptoms of ITP one month after being diagnosed with COVID-19.
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Affiliation(s)
- Michael D Dube
- College of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Sumina Sapkota
- Department of Internal Medicine, Trumbull Regional Medical Center, Warren, USA
| | | | - Anthony Russo
- Department of Internal Medicine, Trumbull Regional Medical Center, Warren, USA
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Sharma N, Shukla R, Warrier R, Kumar K, Singh N, Ghose S, Kumar V. Pancytopenia Secondary to SARS-CoV-2 Infection—a Case Report. SN COMPREHENSIVE CLINICAL MEDICINE 2022; 4:31. [PMID: 35036849 PMCID: PMC8743232 DOI: 10.1007/s42399-021-01085-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/17/2022]
Abstract
Pancytopenia is a condition when a person has a low count of all three types of blood cells, causing a triage of anaemia, leukopenia and thrombocytopenia. It should not be considered a disease in itself but rather a sign of a disease that needs to be further evaluated. Among the various causes, viral infections like the human immunodeficiency virus, cytomegalovirus, Epstein-Barr virus and parvovirus B19 have been implicated. Pancytopenia is a rare complication and is not commonly seen in patients with COVID-19 disease. Here, we report a case of pancytopenia in a previously immunocompetent elderly male patient with SARS-CoV-2 infection.
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Lee H, Thein OS, Muneer T. De novo pancytopaenia in an older adult with severe COVID-19 infection. BMJ Case Rep 2022; 15:e252609. [PMID: 36379633 PMCID: PMC9668033 DOI: 10.1136/bcr-2022-252609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
During the COVID-19 pandemic, it was recognised that SARS-CoV-2 can cause multisystem illness. Non-respiratory complications observed early in the pandemic were haematological in nature. A rare but serious haematological complication of COVID-19 infection is pancytopaenia. We describe a case of an older adult without pre-existing haematological disease or risk factors for cell dyscrasia with severe pancytopaenia induced by COVID-19, who developed critical illness requiring respiratory support in intensive care and died. Our case report highlights that de novo pancytopaenia may only present with mild dermatological manifestations and may indicate severe COVID-19 infection. Management is primarily supportive and early involvement of haematology should be sought.
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Affiliation(s)
- Helena Lee
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Geriatric Medicine, Walsall Manor Hospital, Walsall, UK
| | - Onn Shaun Thein
- Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Respiratory Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Barranco-Trabi JJ, Minns R, Akter R, Park K, Babb S, Masel J. Case Report: COVID Associated Pancytopenia Unmasking Previously Undiagnosed Pernicious Anemia. Am J Trop Med Hyg 2022; 107:tpmd211194. [PMID: 35405638 PMCID: PMC9294700 DOI: 10.4269/ajtmh.21-1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated pancytopenia is a known but rare complication of COVID-19 syndrome that is not well described in literature. Severe acute respiratory syndrome coronavirus 2 has shown the potential to affect any organ including the bone marrow, which then results in a decrease in all three blood cell lines. These cases usually resolve with the passage of time and treatment of underlying risk factors. As COVID pneumonia rates continue to increase worldwide, it is crucial to be able to recognize this complication. Additionally, deeper investigation into patient's response to COVID infection can be complicated by unexpected underlying disease. We report a case of a symptomatic 24-year-old active duty male in Hawaii with post-COVID pancytopenia that was found to have previously undiagnosed pernicious anemia and his response to standard treatment.
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Affiliation(s)
| | - Robert Minns
- Department of Internal Medicine, Tripler Army Medical Center, Honolulu, Hawaii
| | - Roushon Akter
- Department of Internal Medicine, Tripler Army Medical Center, Honolulu, Hawaii
| | - Katherine Park
- Department of Internal Medicine, Tripler Army Medical Center, Honolulu, Hawaii
| | - Sean Babb
- Department of Internal Medicine, Tripler Army Medical Center, Honolulu, Hawaii
| | - Jennifer Masel
- Infectious Disease-Service, Tripler Army Medical Center, Honolulu, Hawaii
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Lancaster I, Patel D, Sethi V, Connelly W, Namey J. Myelodysplastic syndrome in a case of new-onset pancytopenia. Clin Case Rep 2022; 10:e05533. [PMID: 35280084 PMCID: PMC8894573 DOI: 10.1002/ccr3.5533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 11/09/2022] Open
Abstract
Myelodysplastic syndrome (MDS) is an infrequent cause of pancytopenia, which is a decrease in all three peripheral blood cell lines. We report the case of new-onset pancytopenia following administration of a COVID-19 vaccine and recurrent Zosyn use who was later found to have myelodysplastic syndrome.
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Affiliation(s)
- Ian Lancaster
- HCA Healthcare/USF Morsani College of Medicine GME ProgramsLargo Medical CenterLargoFloridaUSA
| | - Deep Patel
- HCA Healthcare/USF Morsani College of Medicine GME ProgramsLargo Medical CenterLargoFloridaUSA
| | - Vikas Sethi
- HCA Healthcare/USF Morsani College of Medicine GME ProgramsLargo Medical CenterLargoFloridaUSA
| | - Weston Connelly
- HCA Healthcare/USF Morsani College of Medicine GME ProgramsLargo Medical CenterLargoFloridaUSA
| | - Joseph Namey
- HCA Healthcare/USF Morsani College of Medicine GME ProgramsLargo Medical CenterLargoFloridaUSA
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Ufuk F, Yavas HG, Kis A. An unusual cause of spontaneous pneumothorax: Post-COVID-19 pulmonary fibrosis. Am J Emerg Med 2021; 49:440.e5-440.e6. [PMID: 33965276 PMCID: PMC8087610 DOI: 10.1016/j.ajem.2021.04.084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Spontaneous pneumothorax (SP) is characterized by the escape of broncho-alveolar air into presence of air in the pleural space without preceding blunt or penetrating trauma. SP requires prompt diagnosis and treatment. SP is divided into two groups as primary and secondary. Primary SP is usually seen in tall and thin patients with no clinically evident underlying lung disease (especially in tall and thin subjects), whereas secondary SP cases have an underlying lung disease, such as cystic lung disease, cavitary lung lesions, severe asthma, emphysema or pneumonia. Patients with Coronavirus-2019 (COVID-19) may experience the SP during the diagnosis and treatment processes, and it is a significant cause of morbidity. However, late-onset SP after recovering from COVID-19 is unusual. Herein we present a case with post-COVID-19 pulmonary fibrosis-like changes and subsequent late onset spontaneous pneumothorax (SP). We also present the patient's radiological findings.
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Affiliation(s)
- Furkan Ufuk
- Department of Radiology, School of Medicine, Pamukkale University, 20100 Denizli, Turkey.
| | - Huseyin Gokhan Yavas
- Department of Radiology, School of Medicine, Pamukkale University, 20100 Denizli, Turkey
| | - Argun Kis
- Department of Chest surgery, School of Medicine, Pamukkale University, 20100 Denizli, Turkey
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Turgay Yıldırım Ö, Yıldız G, Yıldırım S. Conflict in troponin levels in COVID-19 patients. Am J Emerg Med 2021; 43:249. [PMID: 33785237 PMCID: PMC7989100 DOI: 10.1016/j.ajem.2021.03.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Göknur Yıldız
- Eskisehir City Hospital, Department of Emergency Medicine, Eskisehir, Turkey
| | - Selim Yıldırım
- Anadolu University, Faculty of Economics and Administrative Sciences, Department of Economics, Eskisehir, Turkey; Eskisehir Technical University, Graduate School of Sciences, Statistics Department, Eskisehir, Turkey
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Bridwell RE, Inman BL, Birdsong S, Goss S, Long B. A coronavirus disease-2019 induced pancytopenia. Am J Emerg Med 2021; 47:324.e1-324.e3. [PMID: 33653644 PMCID: PMC7902224 DOI: 10.1016/j.ajem.2021.02.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/18/2021] [Indexed: 01/16/2023] Open
Abstract
As the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) pandemic progresses, various hematologic complications have emerged, often centered around the hypercoagulable state. However, pancytopenia represents a rare but serious complication from SARS-CoV2 infection. While lymphopenia is a common finding, concomitant acute anemia and thrombocytopenia are not commonly reported. We describe a novel case of SARS-CoV2 pancytopenia in a 40-year-old male without active risk factors for cell line derangements but subsequent critical illness.
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Affiliation(s)
- Rachel E Bridwell
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.
| | - Brannon L Inman
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
| | - Sara Birdsong
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
| | - Sarah Goss
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
| | - Brit Long
- Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States
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